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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Acute Myocardial Infarction Caused by an Anomalous Right Coronary Artery Occlusion Presenting with Precordial ST

Bruno da Silva Matte1, Alexandre Damiani Azmus1

  • 1Hospital N.S. Conceição, Porto Alegre, RS, Brazil.

Case Reports in Cardiology
|August 10, 2017
PubMed

Insights

Right ventricular infarction can cause ST elevation in precordial leads, mimicking left anterior descending artery occlusion. Successful rescue angioplasty resolved symptoms and ECG abnormalities in a patient with right coronary artery thrombotic occlusion.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Case Study

Background:

  • Acute coronary syndrome (ACS) with precordial ST-segment elevation typically indicates left anterior descending artery occlusion.
  • Isolated right ventricular infarction is an uncommon cause of ST elevation in leads V1-V3.

Observation:

  • A patient with prior inferior wall myocardial infarction presented with new ST-elevation myocardial infarction (STEMI).
  • The STEMI was attributed to proximal right coronary artery thrombotic occlusion.
  • This occlusion led to right ventricular infarction, precordial ST elevation, and sinus node dysfunction.

Findings:

  • Successful rescue angioplasty was performed.
  • The intervention achieved resolution of the patient's acute symptoms.
  • Electrocardiographic abnormalities were also resolved post-angioplasty.

Implications:

  • This case highlights that right ventricular infarction can manifest with precordial ST elevation.
  • It underscores the importance of considering non-LAD occlusions in STEMI presentations.
  • Successful revascularization can effectively manage complex STEMI involving right ventricular infarction and sinus node dysfunction.

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